LITFL Review 349

Welcome to the 349th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest, and deliver a bite-sized chunk of Global FOAM.

The Most Fair Dinkum Ripper Beauts of the Week

The Maryland CC Project shares a lecture from Samuel Tisherman, MD on the work-up and management of the acute abdomen in ICU patients. There is an overview of patient evaluation, classifications of peritonitis and causative microbes, as well as antimicrobial pearls with an emphasis on source control. The lecture ends with the management of abdominal compartment syndrome and the utility/risk of drains and negative pressure vacuum assisted closure. [TCN]

The most recent chapter in the Internet Book of Critical Care covers “community-onset pneumonia,”which groups together the current definitions of CAP and HCAP. This chapter details the complexities of pneumonia diagnosis, the value of an accurate history on the selection of empiric antimicrobial therapy, and the resuscitation of patients presenting with pneumonia. [TCN]

Don’t Forget the Bubbles parses the data from a recent paper that adds to the body of work surrounding the diagnostic dilemma of the otherwise well-appearing febrile infant. The data demonstrated significantly lower rates of serious bacterial infections in febrile infants with a documented viral infection but stressed that bacterial infection cannot be ruled out, especially in infants less than 28 days old. [SN]